Retinal Vein Occlusion: The Case for Prompt Treatment

ReachMD Announcer:
Welcome to Eye on Ocular Health on ReachMD. Today, we’ll hear from Dr. Ashkan Abbey, who’s the Director of Clinical Research at Texas Retina Associates in Dallas. He’ll be discussing the importance of early treatment in retinal vein occlusion.

Let’s hear from Dr. Abbey now.

Dr. Abbey:
In RVO, time really does matter, because persistent edema and high VEGF and inflammatory signaling can drive irreversible retinal remodeling. You want to get to these patients and treat them as fast as possible. That is going to give them the best possible long-term visual prognosis.

We want to limit the duration of macular edema so that we can reduce the risk of chronic cystic changes in the retina, and photoreceptor disruption, and disorganization of the inner retinal layers. And we also want to reduce the downstream complications associated with high VEGF burden. So, you know, getting to it and reducing that VEGF burden quickly and consistently will hopefully prevent the progression to neovascularization, and particularly, neovascular glaucoma, one of the major events that can occur, especially with ischemic CRVO patients. So it's, in a way, a prevention of overall damage to the macula that can lead to permanent vision loss by treating them early, and it’s also a preventative way to avoid future neovascularization that could lead to more catastrophic issues with the eye. So I do believe in aggressively treating patients who are presenting to you with center-involving edema with vision impact. If they are in the office for the first time, I would treat them right then and there, as soon as possible.

One other thing to point out is that we do have data to support the early initiation of intravitreal treatment being associated with superior long-term visual outcomes. And we do also have meta-analyses that confirm that the best outcomes are achieved when anti-VEGF therapy is started promptly after the diagnosis. And any delays in treatment can allow progressive retinal damage from chronic hypoxia and edema, and potentially limit the degree of visual recovery achievable even with subsequent aggressive therapy.

ReachMD Announcer:
That was Dr. Ashkan Abbey talking about why early initiation of treatment in retinal vein occlusion is pivotal. To access this and other episodes in our series, visit Eye on Ocular Health on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!